title: Memantine in dementia: a review of the current evidence.
abstract: BACKGROUND
  As the world's population ages, the incidence of Alzheimer's disease (AD) is projected to double every 20 years. Understanding the pathogenesis of AD and developing effective treatments is a public health imperative. Memantine is a low- to moderate-affinity, non-competitive NMDA receptor antagonist that is currently approved for the treatment of moderate to severe AD.
  
  
  METHODS
  We discuss the current evidence, emphasizing more recent studies examining the effects of memantine in AD. We also look at the gaps in the current knowledge; the studies that will be required to fill these gaps are also discussed. The present paper reviews: the pharmacology of memantine; evidence for its use in moderate to severe AD, as well as in mild to moderate AD; adverse events related to memantine use; its effects specifically on behaviours including aggression and agitation; the pharmacoeconomics of memantine; and the use of memantine in other dementias. Memantine has shown modest benefits in cognition, function, global and behavioural measures, and has shown little potential for drug-drug interactions.
  
  
  CONCLUSIONS
  For the treatment of moderate to severe AD, memantine should be offered as a therapeutic option, either on its own, or in combination with a cholinesterase inhibitor.
authors.affiliation: Division of Geriatric Psychiatry, Sunnybrook Health Sciences Centre, Faculty of Medicine, University of Toronto, Canada.
authors.forename: Nathan
authors.initials: N
authors.lastname: Herrmann
authors.forename: Abby
authors.initials: A
authors.lastname: Li
authors.forename: Krista
authors.initials: K
authors.lastname: Lanctôt
mesh_terms: D000544:Alzheimer Disease / Q000188:drug therapy*; D017850:Economics, Pharmaceutical; D018691:Excitatory Amino Acid Antagonists / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D008559:Memantine / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D015201:Meta-Analysis as Topic; D009483:Neuropsychological Tests
chemical_list: D018691:Excitatory Amino Acid Antagonists; D008559:Memantine